Almost 100 years ago, Maynard Keynes stated that we’d only have to work around three hours a day, and only by choice.

That might seem like a completely ridiculous statement in the modern day, but back then working hours became considerably shorter due to economic progress and technological advances so he had a good reason to think it that momentum would continue.

His prediction was little off, given that I am at the beginning of my eight hour work day as I’m writing this piece. However, he was right about technology’s effect on our productivity.

We can now fit multiple different tasks within our work days that we wouldn’t have been able to do in the past, this is especially true within the medical billing space.

In medical billing, time is extremely important because when it comes to claim submissions there is some serious revenue on the line. A timely filing limit is a constant, lingering due date that healthcare providers need to understand.

Timely Filing Limits

What is a timely filing limit?

Every medical biller is familiar with timely filing limits. If you aren’t, they are a time frame set by each individual insurance company in which a practice or other healthcare company needs to submit their insurance claims.

For example, let’s say a patient visited a doctor’s office on February 20th and the patient has health insurance company ABC. Company ABC has set a timely filing limit to 90 days after the service was rendered.

This means the doctor’s office has 90 days from February 18th to submit that patient’s health insurance claim. In this example, the doctor’s office timely filing deadline would be May 21th.

Why are there timely filing limits?

It may seem unfair that insurance companies place timely filing limits on claims but it ensures that they are sent as soon as possible.

These timely filing limits make it easier for doctors to receive their money and insurance companies to process claims in a (you guessed it) timely manner.

If you look at the terms of any healthcare insurance company, they will almost always have a clause located somewhere within their document that indicates that the payer isn’t responsible for claims they receive outside of their set timely filing limit.

Since insurance companies are legally not responsible, if you send in a claim after the timely filing limit, it will be denied and you will more than likely be forced to write it off.

How are timely filing limits hard?

90 days is plenty of time to submit claims for healthcare organizations because they realize that revenue is on the line and will do anything to get paid as quickly as possible, right?

Generally, a timely filing limit is no less than 90 days but they can sometimes range to 15 months or more. Below we’ve listed some of the biggest healthcare insurance providers, their respective timely filing limit, and the documentation it was sourced from.

CARC 29 has a high chance of prevention but a low overturn rate. Essentially this means that it has a low chance of being appealed, thus you lose money.

“I submitted my claim on time and there were no mistakes but I still received CARC 29. What gives?”

Sometimes you’ll receive CARC 29 even though the claim information was correct and you sent it in on time within that insurance providers timely filing limit.

It is possible that the insurance provider lost or never received the claim you sent due to an error.

If you ever find yourself in that situation, your clearinghouse should offer what’s called a timely filing report, this report should list the date your claim was submitted to the clearinghouse and the payer.

You’re a healthcare practice that just conducted a procedure on a patient. Luckily, that patient has a healthcare insurance provider so your medical billing team can submit a claim. All of this happens in around 2 hours, right? Actually, healthcare claim submission is a bit more complicated and takes much longer.

In medical billing, time is extremely important because when it comes to claim submissions there is some serious revenue on the line. A timely filing limit is a constant, lingering due date that healthcare providers need to understand.

As a healthcare provider, one of the most frustrating facets of working within the industry is inevitably facing denied insurance claims. Whether it happens due to expired insurance, or your employees entering the information incorrectly, it's something that all healthcare providers have to pay particular attention to. If these denied claims are not managed properly, healthcare providers could lose thousands of revenue dollars.

Think about how much information your doctor’s office has to digest within one day. Let’s say it’s a small healthcare provider that sees an average of 20 patients on any given day. Each of these patients has different health insurance’s that all process and respond differently. Now imagine how many patients have different health insurance’s in a larger practice or even a hospital, the numbers add up quickly.

We are pleased to announce a new partnership as EncounterWorks' preferred clearinghouse. We look forward to working with their clients and place a special emphasis on the customer service we provide for them. Furthermore, current EncounterWorks clients can look forward to a plethora of new features that make it easier than ever to send and receive claims.

30 years ago, the first data exchange occurred between two companies via an electronic medium. They didn’t realize it at the time, but those two companies participated in what is now known as EDI or Electronic Data Interchange. Originally, EDI was inspired by military logistics as a way to exchange vast quantities of data. Since then, millions of users, organizations, and government agencies participate in EDI every day.

Etactics, Inc. has reached a new record for the most successful webinar held! Registered attendees reached well over 100! On June 25th 2015, Etactics held an educational webinar "Preparing a Denials Management Prevention and Appeals Strategy for the coming ICD-19 World. The presentation was given by Senior Vice President Carl Trownson. The webinar was 40 minutes long and highlighted ways to prevent denials for upcoming ICD-10. ICD-10 will be implemented October 1st 2015, and claim error rates are expected to more than double.